Breast Cancer Screening : Why and how you should regularly do it at home

Breast cancer is the most common cancer seen worldwide as well as in India. It is a type of cancer that arises from breast cells when they start increasing abnormally to the extent of tumor formation. Although there is a high incidence of benign growth, especially in females of the reproductive age group, many breast cancer cases have been seen in women < 30. The recommended age for breast cancer screening is 40-50 years annually despite increasing incidence in young women.

There is no organized, systematic, government-funded screening program for breast cancer in India. Like other developing countries, screening can be considered opportunistic screening; that is, only patients who ask health care professionals for a screening test will be advised of the test.

There can be various reasons for the nonexistent screening recommendations in our country, including a large population or lack of awareness regarding the gravity of the illness or lack of resources. But as we grow close to the developed nations in terms of technology and development, we should focus on our health and become more responsible for decisions regarding our health as we cannot depend on the unformed laws for breast cancer screening.

Screening

Most common screening test for breast cancer.

• Magnetic resonance imaging (MRI) may be used to screen women who have a high risk of breast cancer.

• Other screening tests have been or are being studied in clinical trials.

o Self-Breast Exam

o Clinical Breast Exam o Tissue sampling

• Most women are advised Breast Mammography, an X-ray of the breast, although according to the ACS guidelines, women with 20-25% or greater lifetime risk of breast cancer should undergo screening MRI. Self Breast Exam Breast self-exam, or regularly examining your breasts on your own, can be an important way to find breast cancer early when it’s more likely to be treated successfully.

You can do a practical Self Breast exam by following these steps:

1.Start by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. What to look for?

• Notice the size, shape, and color of your Breasts

• Breasts should be evenly shaped without visible distortion or swelling, although there might be a slight variation in the size of both breasts sometimes.

2: Now, raise your arms above your head and repeat step 1.

3: You can do an examination either sitting in front of a mirror or while bathing. Notice the nipple and any signs of discharge(fluid) from one or both the nipples. Discharge can be watery, milky, or yellow, or bloody.

4: Feel your breasts while lying down using your right hand for the left breast and your left hand for the right breast. Use a firm yet smooth touch with the few finger pads of writing, keeping fingers flat and together. Use in a circular motion in one direction. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen and from your armpit to your cleavage. Make sure to examine the whole breast. You can start from the nipple, moving in larger and larger circles until you reach the outer edge of the breast, or you can move vertically up and down in rows. You can use a light touch for skin and a firm hand for deep structures of the breast.

The first time, you would feel confused if you are doing it right, but make it a point and do it every month around the same time, preferably seven days after your periods get over. As you become regular, you will start knowing your breast, and you would be able to assess what is expected and what is not. If you no longer have periods, choose a fixed day of the month and repeat the same day every month.

Why should we do Breast cancer Screening?

Over 40 % of breast cancer are detected by patients themselves rather than the doctors. Every 2 minutes, a woman is diagnosed with breast cancer. Late detection reduces survival by 3-17 times. On the contrary, if we can detect cancer in early stages, we would be able to increase the chances of cure and survival. Late detection of breast cancer can increase the cost of treatment by as much as 1.5-2 times than the cost of early-stage cancer.

Apart from women, 1% of breast cancer cases are seen in men, and this is a very disregarded fact as the screening guidelines are recommended only for women. Now that we have covered why do we need to know about breast cancer, let’s discuss the risk factors of the breast cancer: Like other cancer, breast cancer also have certain risk factors which if present can increase the risk of development of breast cancer, but if necessary steps are taken, outcomes can be improved by either reducing the risk factors or diagnosing the breast cancer in initial stages. 

Risk factors 

Old age Early menarche(age of period starting), Late menopause Nulliparity (no child) or first child in 40s, Lifestyle risk factors- High intake of saturated fat Body Mass Index >35, Excess alcohol intake Smoking Sedentary lifestyle, History of breast cancer in the family, Hormone replacement therapy BRCA 1 or 2 mutation, History of radiation exposure. Although all risk factors can’t be avoided, modifiable risk factors like smoking, alcohol or sedentary lifestyle, and obesity are the ones that, if altered, can significantly reduce the risk of breast cancer. 

Breastfeeding is considered protective in breast cancer, so all women are advised to breastfeed their children. It is not clear why only some women with risk factors develop breast cancer, whereas some women with no risk factors can also develop breast cancer. Almost 5-10 percent of breast cancer patients have a positive family history of the disease, making it essential for aggressive screening methods in those individuals. 

SYMPTOMS OF BREAST CANCER

 • A breast lump or thickening that feels different from the surrounding tissue of the breast

• Change in the size, shape, or appearance of the breast

• Changes in the skin over the breast, such as dimpling, puckering, inflammation, shiny skin,

• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin

• Redness or pitting of the skin over your breast, like the skin of an orange

• Newly inverted nipple 

WHAT TO DO WHEN YOU NOTICE A LUMP IN YOUR BREAST? 

The first thing is not to panic, as the breast is made up of fatty tissue, and sometimes a lumpy breast can give a false impression of a lump. The second thing is to schedule an appointment with a physician/surgeon and get it clinically evaluated. All suspected nodes are evaluated by mammography, and if there is any suspicion of tumor, a small tissue sample is aspirated from the lump to confirm the diagnosis. Remember, the one person who is an expert on your body is you. So get to know your body well, make an effective plan to include self-breast examination in your routine, and always consult experts’ opinions when in doubt.

Stay safe and stay healthy. 

Article Credit: Dr. Kavita,MD Radiation Oncology, Delhi

For more topics on health, visit Dr. Kavia on www.delayed.in or Follow on: https://www.instagram.com/drkay.md/

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